Healthcare Insurance

Claim

Healthcare Insurance

Client visiting doctor and collecting document

Client submit claim document to claim handling unit (TPA)

TPA sends notification on claim receiving (to sufficient docs) or notification on additional document requirement (to insufficient docs)

TPA handles the claim and sends notification of claim solution (to the claim under coverage) or notification of claim declination (to the claim out of coverage)

TPA transfers reimbursed amount to the bank account registered in claim form

Client feedback if disagree to claim result. TPA discusses to client, in case of adjusting claim solution, TPA will rehandles and transfers additionally.

Required claim document

Claim form (UIC form)
Copy of ID card / Passport / Birth certificate
Conversion invoices pay for medical and surgical expenses incurred during the process treatment process.
Diagnosis by a doctor.
Documents proving medical and surgical expenses incurred during the period treatment process such as: medical records, prescriptions, test results, X-ray, detailed statement of hospital fees (in case of hospitalization).
hospital)…These documents must have the hospital’s seal
Hospital discharge papers (in case of inpatient treatment)
Police records, confirmation from authorities or related parties about the case (if requested)
Driver’s license (depending on the case)
Excerpt of death certificate (in case of death).
Other documents upon request depending on the case

*For claim payment timeline: 15 days from the date of receipt of complete and valid original documents for claim and insurance payment.